U.S. patent application number 10/510384 was filed with the patent office on 2005-10-27 for reamer spindle for minimally invasive joint surgery.
Invention is credited to Davies, Hugh, Lechot, Andre, White, Michel Patrick.
Application Number | 20050240192 10/510384 |
Document ID | / |
Family ID | 29407787 |
Filed Date | 2005-10-27 |
United States Patent
Application |
20050240192 |
Kind Code |
A1 |
Lechot, Andre ; et
al. |
October 27, 2005 |
Reamer spindle for minimally invasive joint surgery
Abstract
An adjustable reamer spindle is provided to aid the surgeon in
controlling the instrument. The reamer spindle is easily
disassembled for cleaning. The spindle has a repositionable handle,
a locking ring, and an elastic device. The elastic device biases
against a handle locking mechanism that locks the repositionable
handle at angular positions about an axis of the spindle. The
elastic device further biases a locking ring into a locked
position. The locking ring aids in holding the reamer spindle
together. Removal of the locking ring against an elastic bias of
the elastic means unfastens an end of the assembly in order to
facilitate disassembly and/or cleaning. Adjustment of the position
of the handle about the spindle enables the palm/grip of each hand
to be changed in order to provide maximum control in different
orientations. The adjustment is desirable in order to accommodate
operating on the left or right side of the patient, standing behind
or in-front of the patient, or the use of a different surgical
approach. Further, adjustment is important to accommodate the
differing needs of surgeons who are naturally left or right
handed.
Inventors: |
Lechot, Andre; (Orvin,
CH) ; Davies, Hugh; (Shelley, GB) ; White,
Michel Patrick; (West Chester, PA) |
Correspondence
Address: |
John Moetteli
Bugnion S A
10 Route De Florissant
P O Box 375
Ch-1211 Geneva 12
CH
|
Family ID: |
29407787 |
Appl. No.: |
10/510384 |
Filed: |
October 5, 2004 |
PCT Filed: |
April 28, 2003 |
PCT NO: |
PCT/IB03/01725 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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60376479 |
Apr 30, 2002 |
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60384186 |
May 30, 2002 |
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60459594 |
Apr 2, 2003 |
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Current U.S.
Class: |
606/80 |
Current CPC
Class: |
A61B 2017/320032
20130101; A61B 17/1633 20130101; A61B 17/1666 20130101; A61B
17/1631 20130101; A61B 50/30 20160201 |
Class at
Publication: |
606/080 |
International
Class: |
A61B 017/32 |
Claims
1. A surgical reamer spindle (15, 115) which is easily disassembled
for cleaning, the spindle being elongated, having first and second
ends and a central housing (113, 213, 313, 314, 413, 414, 502), the
housing substantially enclosing a drive train (207) and comprised
of at least two housing members (113, 213, 313, 314, 413, 414),
wherein at least one of the first and second ends is retained in a
drive-train-enclosing relationship by a capture mechanism (455,
490, 486, 502) comprising a locking ring (455) and an elastic
device (486), the locking ring biased in a locking position by the
elastic device, the at least two housings being separable from one
another approximately along a plane substantially parallel to a
longitudinal axis (116) of the housing to permit cleaning and/or
changing out of the housing members for other housing members of a
different form in order to suit different surgical protocols.
2. The surgical reamer spindle of claim 1 wherein the capture
mechanism (455, 490, 486, 502) further comprises a locking sleeve
(482a) to which a repositionable handle (500) is attached, wherein
the elastic device (486) is disposed between the locking sleeve and
the locking ring so as to bias the locking ring in a locking
position and to bias the locking sleeve, and thus attached
repositionable handle, into a locked angular position about an axis
(116) of the spindle, the locking ring aiding in holding the reamer
spindle together, wherein removal of the locking ring against an
elastic bias of the elastic means unfastens an end of the assembly
in order to facilitate disassembly and/or cleaning.
3. The surgical reamer spindle of claim 2, wherein the locking
sleeve (482a) has recesses (482c) for receiving pins (484) engaged
in a shoulder (502c) fixed to the housing, the locking sleeve, and
thus the adjustable handle (500), locking when the pins are
received into the recesses, thereby locking the locking sleeve to
the shoulder and thus to the housing.
4. The surgical reamer spindle of claim 2, wherein the locking ring
(455) has at least one pin (411) affixed thereto, the at least one
pin locking the locking ring in a locking position when the locking
ring is biased into a bayonet recess (260, 492) by the elastic
device (486).
5. The reamer spindle of claim 1, wherein the drive train (207) is
selected from a group of drive trains consisting of nickel titanium
drive trains, ferrous metal drive trains, flexible round wound
cable drive trains, flat wire wound cable drive trains, gear-driven
shaft drive trains, and drive trains having shafts connected via
universal joints.
6. An elongated surgical reamer spindle (315) having an adjustable
handle (500) which is easily disassembleable for cleaning, the
spindle having first and second ends and a central housing (113,
213, 313, 314, 413, 414, 502), the housing substantially enclosing
a drive train (207), wherein an lockable adjustment mechanism (450)
adjustably locks the handle in angular positions about the spindle,
the lockable adjustment mechanism comprising a locking ring (455)
and a locking sleeve (482a) to which the adjustable handle is
connected, wherein further an elastic device (486) is disposed
between the locking sleeve and the locking ring so as to bias the
locking ring in a locking position and to bias the locking sleeve,
and thus the handle, in a selected angularly locked position about
the housing, wherein removal of the locking ring against the bias
of the elastic device facilitates disassembly of the spindle for
cleaning.
7. The surgical reamer spindle of claim 6, wherein the locking
sleeve (482a) has recesses (482c) for receiving pins (484) engaged
in a shoulder (502c) fixed to the housing, the locking sleeve, and
thus the adjustable handle (500), locking when the pins are
received into the recesses, thereby locking the locking sleeve to
the shoulder and thus to the housing.
8. The surgical reamer spindle of claim 6, wherein the locking ring
(455) has at least one pin (41) affixed thereto, the at least one
pin locking the locking ring in a locking position when the locking
ring is biased into a bayonet recess (260, 492) by the elastic
device (486).
9. The surgical reamer spindle of claim 8 wherein the drive train
(207) is selected from a group of drive trains consisting of nickel
titanium drive trains, ferrous metal drive trains, flexible round
wound cable drive trains, flat wire wound cable drive trains,
gear-driven shaft drive trains, and drive trains having shafts
connected via universal joints.
10. A surgical reamer spindle kit (600) including: a surgical
reamer spindle as claimed in claim 1 with a drive train (207)
having, at one end thereof, a reamer holder (120); and at least one
matching pair of housing members (313, 314; 413, 414) adapted for
receiving the drive train and constraining the drive train in an
operational orientation.
11. The surgical reamer spindle kit of claim 10 comprising at least
two matching pairs of housing members (313, 314; 413, 414) of
differing form, each form suitable to suit different surgical
protocols.
12. The surgical reamer spindle kit of claim 10 further comprising
at least one surgical reamer (1).
13. The surgical reamer spindle kit of claim 10, further comprising
a femoral prosthesis (604).
14. The surgical reamer spindle kit of claim 10, further comprising
an acetabular cup prosthesis (606).
15. The surgical reamer spindle kit of claim 10, further comprising
an impactor (602).
16. The surgical reamer spindle kit of claim 10 further comprising
a sterilization case (610).
17. A surgical reamer spindle kit (600) including: a surgical
reamer spindle as claimed in claim 6 with a drive train (207)
having, at one end thereof, a reamer holder (120); and at least one
matching pair of housing members (313, 314; 413, 414) adapted for
receiving the drive train and constraining the drive train in an
operational orientation.
18. The surgical reamer spindle kit of claim 17 comprising at least
two matching pairs of housing members (313, 314; 413, 414) of
differing form, each form suitable to suit different surgical
protocols.
19. The surgical reamer spindle kit of claim 17 further comprising
at least one surgical reamer (1).
20. The surgical reamer spindle kit of claim 17, further comprising
a femoral prosthesis (604).
21. The surgical reamer spindle kit of claim 17, further comprising
an acetabular cup prosthesis (606).
22. The surgical reamer spindle kit of claim 17, further comprising
an impactor (602).
23. The surgical reamer spindle kit of claim 17 further comprising
a sterilization case (610).
Description
BACKGROUND OF THE INVENTION
[0001] This invention relates to handles for reamers, and, more
particularly, to adjustable handles for acetabular reamers that can
be easily sterilized.
[0002] Complicated mechanical devices have crevasses and recesses
that are difficult, if not almost impossible, to clean with ease.
Devices that are not properly cleaned and sterilized contribute to
the risk of disease transfer from patient to patient following the
emergence of certain "prions" that are not killed by normal
hospital sterilisation and need to be physically removed by
washing/rinsing.
[0003] In GB PCT application no GB0202934A to Chana, entitled,
Improved Surgical Devices and Methods of Use, the contents of which
are incorporated by reference hereto, several reamer spindle
designs are discussed. However, none includes a handle having the
ability to be angularly repositioned about the axis of the housing
and none uses a single spring to both lock the angularly
repositionable handle in place and to lock the two housing portions
in place.
[0004] What is needed therefore is a reamer spindle that is easily
adjustable, disassemblable, and cleanable and which includes an
easily repositionable handle using a mechanism requiring few
components.
SUMMARY OF THE INVENTION
[0005] An adjustable reamer spindle is provided to aid the surgeon
in controlling the instrument. Adjustment of the position of the
handle axis of the spindle enables the axis through the palm/grip
of each hand to change in order to provide maximum control in
different orientations. The adjustment is desirable in order to
accommodate operating on the left or right side of the patient,
standing behind or in-front of the patient, or the use of a
different surgical approach. Further, adjustment is important to
accommodate the differing needs of surgeons who are naturally left
or right handed. Thus, the comfort for holding and using the
instrument is enhanced through adjustment.
[0006] In an objective of the invention, the handle can be easily
cleaned, in that the design access to all surfaces such that they
can be cleaned (i.e., one part covering another can be moved or
removed to expose all surfaces). Further, the design enables the
reduction in number of small radius internal corners, crevasses and
small gaps and the absence of blind holes.
[0007] In another objective, a reamer handle is provided that is
easy to disassemble and for which the disassembly is easy to
learn.
[0008] In another object, the invention minimises the number of
pieces and thus the risk that any individual part might be
lost.
BRIEF DESCRIPTION OF DRAWINGS
[0009] The attached drawings represent, by way of example,
different embodiments of the subject of the invention.
[0010] FIG. 1 is a side view of the reamer spindle of the present
invention.
[0011] FIG. 2 is a top view of the reamer spindle of the present
invention.
[0012] FIG. 3 is a section view taken along line 3-3 shown in FIG.
2.
[0013] FIG. 4 is a plan view showing a traditional reamer spindle
of the prior art being used in a minimally invasive approach for
reaming the acetabular socket.
[0014] FIG. 5 is a plan view showing the reamer spindle of the
present invention being used in a minimally invasive approach for
reaming the acetabular socket.
[0015] FIG. 6 is an exploded assembly of an alternative embodiment
of the present invention.
[0016] FIG. 7 is an alternative shape housing of the alternative
embodiment shown in FIG. 6
[0017] FIG. 8 is a perspective view of an alternate embodiment of
the invention having a repositionable handle.
[0018] FIG. 9A is an exploded view of the alternate embodiment of
FIG. 8.
[0019] FIG. 9B is a close up of a portion of the exploded view of
the alternate embodiment of FIG. 8.
[0020] FIG. 9C is a cross-sectional view of the adjustable handle
portion of the alternate embodiment of FIG. 8.
[0021] FIG. 10 is a perspective view of key components of the
alternate embodiment of FIG. 8.
[0022] FIG. 11 is a plan view of a surgical reamer kit of the
invention.
DETAILED DESCRIPTION
[0023] The reamer spindle 115 shown in FIGS. 1-3, and 5 consists of
a drive fitting 104, which is adapted to be joined to a rotary
power source used to drive the shaft 107 of the reamer spindle 115.
The shaft 107 is mounted to a reamer holding mechanism 120. The
reamer holding mechanism 120 can be selected from a variety of
mechanisms useful for capturing and holding a surgical reamer 1
during an orthopedic surgical procedure. It is clear that many
different mechanisms exist which would be useful for this task,
however the present inventors have selected the preferred bayonet
style mechanism 120 for purpose of example. The reamer holding
mechanism 120 comprises a slide 106 carrying a pin component 111 of
the reamer holding mechanism 120. The pin 111 works cooperatively
with the catch 110 located in the head 108 to form the bayonet for
capturing different size reamers 1 while allowing their easy
release for size interchangeability and cleaning. The reamers 1
selected for use with the reamer spindle 115 can be shaped and
sized for cutting different osseous sites within the body. It is
widely known that reamers can be designed to cut the patella in a
knee or the glenoid in a shoulder or the socket 45 in an acetabulum
40 as shown in FIGS. 4-5.
[0024] Referring to FIGS. 4-5, the reamer spindle 115 of the
present invention and the spindle 15 of the prior art invention are
shown passing through a miniature incision 35 in the patient's skin
30. In FIG. 4, the reamer spindle 15 is shown approaching the
acetabulum 40 in a preferred orientation for reaming the socket 45.
The difficulty with the prior art spindle 15 is shown as the shaft
3 impinges on the miniature incision 35 at edge of the incision 37.
The current surgical protocols are being pushed to the limits and
the incision sizes are being reduced in the hopes of increasing the
patient's speed to recovery. In some cases surgeons are using a
two-incision approach, one to reach the acetabulum and the other to
reach the femur. Depending on the situation, either the one
incision or the two incision technique results in less trauma to
the patient, thus requiring the instruments to be flexible and more
optimally designed to make up for the lack of operating space.
[0025] The reamer 115 of FIG. 5 shows a new reamer spindle 115,
which has a bent housing 113 containing the drive shaft 107. The
drive shaft 107 can be selected from a variety of current torque
transmitting mechanisms or devices including a Nickel Titanium
shaft, a flexible round or flat wire wound cable, a series of gear
driven shafts, or a series of shafts interconnected by universal
joints. The drive shaft 107 can also be selected from any torque
transmission mechanism or device deemed appropriate for the
application. The drive shaft 107 can be held to the housing 113
with an optional series of bearings 118-119 which keep the drive
shafts from bearing against/riding on the inside of the housing 113
and act as a shield to protect the inner housing from blood. Other
means for holding the shaft to the housing would be acceptable. The
most important feature of the drive shaft 107 is that it conforms
to the selected housing 113 and sufficiently supplies torque to the
cutter 1.
[0026] The housing 113 is formed from cannulated material and the
drive end 104 is substantially collinear with the holding mechanism
120 along axis 116. Referring now to FIG. 8 et seq., alternatively,
the drive end 104 could be situated along an axis parallel or
offset to axis 116. The bends in the housing are optimally placed
at critical locations to pass through the miniature incision
without impinging on the skin 30 at location 37 while still
maintaining the same surgical protocol. The drive end 104 and the
holding mechanism 120 should be in line or on parallel axes so that
the applied force 130 results in an axial motion 140. This allows
the surgeon to maintain the existing technique because inherently
reamer spindle 15 in FIG. 4 would give the same result since it has
a straight drive shaft 3. Thus, the surgeon is allowed to apply a
load directly along the path of reaming.
[0027] Referring now to FIG. 6, an alternative embodiment is shown.
Similar to FIGS. 1-3 and 5, the reamer spindle 215 has a drive
fitting 204, which is adapted to be joined to a rotary power source
used to drive the shaft 207 of the reamer spindle 215. The drive
shaft 207 can be selected from a variety of current torque
transmitting mechanisms or devices including a Nickel Titanium
shaft, a flexible round or flat wire wound cable, a series of gear
driven shafts, or a series of linkages 208 interconnected by
universal joints 209. The drive shaft 207 can also be selected from
any torque transmission mechanism or device deemed appropriate for
the application. In this embodiment, the shaft 207 is constructed
from a series of linkages 208 containing universal joints 209 and
bearing members 218.
[0028] The reamer holding mechanism 220 is preferably a bayonet
fitting with a slide 206 carrying a pin component 211 of the reamer
holding mechanism 220. The pin 211 works cooperatively with the
catch 210 located in the head 208 to form the bayonet for capturing
different size reamers while allowing their easy release for size
interchangeability and cleaning. The drive shaft 207 is set in
housing members 213 and 214, which are separable for cleaning.
[0029] There are many ways of connecting the housing members 213
and 214 together. For example, the shaft 207 can include a capture
mechanism 247 which is adapted to receive the front ends of the
housing members 213 and 214 aligning each with one another and
encapsulating the drive shaft 107 to protect the patient's skin
from contacting the torque transmitting shaft 207 during operation.
Once the housing members 213 and 214 are aligned, a locking
mechanism 250 comprised of a ring 255 and a catch 260, which is
located in the housing member 213, interact with one another to
retain the housing members 213 and 214 in a closed fashion. As with
the embodiment described in FIGS. 1-3, and 5, it is preferable to
have the drive end 204 substantially collinear with the holding
mechanism 220 along axis 216. The housing members 213 and 214 are
shown preferably in a bent configuration; however, the reamer
spindle 215 with a separable housing includes the option of a
straight configuration, as is the case with housing members 313 and
314, shown in FIG. 7, having no bend.
[0030] Referring now to FIG. 8, in another embodiment 315, the
drive end 404 is situated along an axis parallel and offset to axis
416. Further, a repositionable handle 500 doubles as a component of
the capture mechanism 447 in order to hold the two housing members
413 and 414 together.
[0031] The capture mechanism 447 slides over the front ends 448 of
the housing members 413 and 414, aligning each with one another and
thus encapsulating the drive shaft 107 in order to protect the
patient's skin from contacting the torque transmitting shaft 107
after being assembled.
[0032] FIGS. 9A, 9B and 9C more clearly show how the housing
members 413 and 414 are aligned and locked in place. The housing
members 413 and 414 are oriented with respect to each other when a
locking sleeve 502a (having an internal diameter larger than the
outside diameter of the housing members) slides over them, abutting
against a bend 480 in the housing members. Thin, annular Teflon
sleeves (not shown) are disposed between the housing members 413
and 414 and the locking sleeve 502a to facilitate disassembly. A
forward mouth section 502b of the locking sleeve 502a cradles the
bend 480 of the housing members 413 and 414 so as to prevent
relative rotation of the locking sleeve and housing members. At the
front 448, the capture mechanism 447 has a locking device 450 which
includes an annular sleeve 482 onto which the handle 500 is
affixed. The sleeve 482a includes a face 482b having recesses 482c
(shown in FIG. 9C) into which pins 484, fixed to a shoulder 502c of
the locking sleeve 502, are received in order to torsionally
rigidly hold the handle 500 in any one of eight positions,
according to the preference of the surgeon. A spring 486 biases the
annular sleeve 482a into engagement with the pins 484 via, on the
one hand, applying spring pressure against an internal shoulder
482c (shown in FIG. 9C) in the annular sleeve 482a and, on the
other hand, reacting against a locking ring 455. The locking ring
455 includes pins 490 which are affixed thereto and which enter
into bayonet slots 492 in the locking sleeve 502 in order to hold
the locking device 450 on the end of the locking sleeve and thus
the capture mechanism 447 together. The housing members 413 and 414
are held together via the pins 490 which engage the bayonet slots
492 in each of the housing members 413 and 414 (best shown in FIG.
10 in which the annular sleeve 502, the spring 486 and the locking
sleeve 502 are removed for clarity). The pins 490 of the locking
ring 455 and a catch 260 interact with one another to retain the
housing members 413 and 414 in a closed fashion while concurrently
biasing the spring 486 so as to engage the annular sleeve 482a (and
thus the handle 500) with the pins 484. Further, sufficient play in
the axial movement of the annular sleeve 482a is permitted to
enable the surgeon to selectively disengage the sleeve from the
pins 484 so as to reposition the handle about the locking sleeve
502a in any one of the eight angular positions of the handle 500,
while avoiding disassembly of the spindle 115.
[0033] Referring now to FIG. 11, collectively, these different
types of housing members 213-214, 313-314, and 413-414 can be
offered as a kit 600 having a selection of different sized reamer
housings 113 together with an impactor 602, acetabular implants
(not shown), femoral hip prostheses 604, and acetabular cup
prostheses (606), the selection of different reamer housing
configurations allowing the surgeon to select between a bent,
offset configuration or a straight configuration of the reamer
spindle 115, 215, and 315 depending on the surgeons approach, which
may vary during the same operation or between different
patients.
[0034] Multiple variations and modifications are possible in the
embodiments of the invention described here. Although certain
illustrative embodiments of the invention have been shown and
described here, a wide range of modifications, changes, and
substitutions is contemplated in the foregoing disclosure. In some
instances, some features of the present invention may be employed
without a corresponding use of the other features. Accordingly, it
is appropriate that the foregoing description be construed broadly
and understood as being given by way of illustration and example
only, the spirit and scope of the invention being limited only by
the appended claims.
* * * * *